Reduce the Ongoing Risk of Arthritis – The Importance of Healing Damaged Knee Ligaments

By  aenriquez  published  December 6, 2017

Ongoing Risk of ArthritisAs the largest and perhaps most important joint in the body, the knee joint is an easy one to injury. Through twisting or moving awkwardly, there can be a strain on the joint and even if overusing, this can create knee pain. The knee joint takes a great deal of pressure and weight-bearing and this, along with natural aging are all likely causes of joint problems. Mild strains are likely where the tissues of the knee are stretched but minor aches and pains are unlikely to need medical assistance. Protecting, resting and using ice to relieve any inflammation is wise but ensuring flexibility is maintained and good muscular strength is present around the knee joint will help in a preventative manner. During recovery from any sprains, it’s useful to keep the leg elevated as much as is possible.

It is wise to take preventive measures to knee joint health because a severe injury could lead to a greater risk of ligament issues or, even arthritis in the long term:

  • Take a measured approach to increasing activity levels
  • Wear good fitting sports shoes
  • Warm up prior to exercising and stretch as part of the cool down process
  • Try low-impact exercises which will not injure the knee joints

Any injury to the knee joint could be costly. Damage to the joint will certainly affect movement, flexibility and, once weakened, it is likely that the individual will suffer from future pain or a reduction of mobility. According to Dr. Mininder Kocher, an orthopedics professor at Harvard Medical School, the potential to develop arthritis in the knee joint following a tear to a tendon or ligament is more than 50 percent. Therefore, treatment and due consideration to the health of the joint is paramount. Arthritis is very common and pain, swelling, and stiffness in the joint are typical.

The knee is a modified hinge joint which enables extension and flexion. It also enables external and internal rotation to a certain degree. There are three compartments; the patella (kneecap) the patellar groove on the front of the femur and the medial and lateral tibiofemoral articulations which connect the femur to the tibia. The joint capsule contains synovial membrane and fluid.

Knee joint pain can be considerable and where the severe injury occurs to the lateral collateral ligament (LCL) perhaps a severe sprain or if torn, the individual will experience stiffness, swelling, pain on the outside of the knee and a weakness in the joint. Partial LCL injuries may not demonstrate many symptoms. The LCL is one of four ligaments to help stabilize the joint but, this is the most common of LCL injuries.

It is easy to injure the LCL:

  • Over-stretching or over-use
  • Hyperextension of the knee
  • Twisting movements or a sudden change of direction

Injuries are graded accordingly. A grade 1 LCL sprain means that the ligament did not tear although there is the risk of further injury. A grade 11 LCL sprain means that there is partial tearing to the ligament and some symptoms will be experienced. When a grade 111 LCL sprain occurs, the ligament will have torn completely and there may be bleeding beneath the skin. If all the pain fibers are torn at the same time, there will be little to no pain.

Recovery – depending on the grade of injury may take up to four months. Minor injuries take much less healing time. Certainly, physiotherapy treatments will accelerate the healing process via massage, joint exercises, and electrical modalities. They will also guide the way that the knee ligament fibers heal. This can also help to reduce the potential to tear this ligament again. An MRI may be used for diagnostic purposes to be sure that there are no other combination injuries. Knee surgery may be required especially where there is a combination of injuries. Rehabilitation thereafter will focus on being able to increase strength to the joint and to restore the full motion of the knee. This will also help to reduce the risk of arthritis.

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Healing and Recovery for Shoulder Dislocations and Lesions

By  aenriquez  published  November 29, 2017

Recovery for Shoulder Dislocations The shoulder joint is extremely mobile enabling the upper arm to move in most directions with ease but, this also makes it an unstable joint and easy to injure. When a dislocation occurs, the pain can be significant and when the shoulder is severely injured, the nerves and tissues around the joint become damaged, resulting in ongoing weakness.

It is relatively easy to dislocate the shoulder joint:

  • Falling – in particular, landing directly on the shoulder on a hard surface.
  • Direct injury to the shoulder
  • Falling but the brunt of the weight is directed through an outstretched hand.
  • A sharp twist on the arm

Within the shoulder joint, the humerus head sits in the glenoid fossa, a shallow extension of the scapula, and, because of the shallowness of this area, the structures around the joint must maintain stability.  The labrum extends from the glenoid fossa and enables a deeper vessel for the head of the humerus. The tissues surrounding the joint also help to provide stability with tendons and rotator cuff muscles providing protection. When the head of the humerus is removed from its position in the socket, it is dislocated, and the type of dislocation is described by the positioning of where it is. Most dislocations are anterior dislocations – approximately 95%. This simply means that the humeral head moves in front of the joint. Posterior dislocations move towards the shoulder blade.

When the injury first happens, the shoulder can be immobilized by placing the arm in a sling and it can also be useful to apply an ice pack to the shoulder area. It is advisable to seek medical care so that a diagnosis can be made, and treatment given to repair the dislocated shoulder. The restricted movement to the upper arm and shoulder area and even some deformation of the shoulder is likely if it is dislocated. If the upper arm bone comes out of the shoulder socket, the force of this could tear the labrum, a ligament, causing a bankart lesion. It is common with dislocations to the shoulders and most connected to the instability of this joint. Initially, a doctor would be concerned with joint relocation and pain management, but to treat fully, they need to understand the circumstances of the injury and whether any dislocation has happened previously. Muscles spasms are likely and there will be various levels of pain.  Surgery, by way of a bankart repair, may be necessary.

The labrum – which is essentially a fibrous ring located within the shoulder socket, can be repaired following a small incision which enables the specialist to view the damage via a tiny camera. The damaged labrum and any other ligaments are re-attached and then, tightened using sutures or anchors. Surgery takes between 1.5 hours and 2.5 hours and a regional block are used to help numb the area. There is usually an overnight stay in the hospital, but the stitches must stay in place for up to 14-days.

Following surgery, the orthopedic surgeon may provide antibiotics and pain medication to ease pain and discomfort but also, as a preventative measure to prevent infection setting in. Ice packs are often recommended to help with any pain experienced. Physical therapy is also recommended during the recovery process to increase mobility. It is possible to recover completely from a shoulder dislocation although recovery may take some time, certainly, there are considerations to be made and older patients and those with diabetes could have a higher hospital admission rate.

 

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How Long Does It Take To Recover From A Broken Femur?

By  aenriquez  published  November 22, 2017

Recover From A Broken FemurA femur fracture is a crack, break or crush injury to the thigh bone. Smaller, simpler fractures of the femur do not typically require surgery. However, others that completely break the bone, cause the bone to be crushed or displaced need immediate surgery.

Symptoms of a femur fracture

A fracture in the thigh bone can bring about the following symptoms:

  • Inability to stand or move the leg
  • Swelling in the hip region
  • Bleeding from an open wound
  • Deformity of the thigh bone region
  • Hematoma
  • Thigh muscle spasms
  • Tingling or numbness in the leg

Diagnosing the condition

This is a serious injury that is usually diagnosed by a physician. The physician will look for symptoms of a fracture mentioned above along with the help of an X-ray or CT scan.

Based on the nature of the injury, treatment may involve immediate admission to the hospital for surgery or extensive treatment in a rehabilitation facility.

Recovery times

Because the femur is so strong, it often takes a lot of force to break it.

  • The cause is usually some type of high energy collisions such as a car or motorcycle accident.
  • A severe sports injury could also have the effect for athletes of young people.
  • Even a low force incident such as a fall can cause a broken femur in individuals with weak bones.
  • In the elderly, broken femur may be caused by a slip or fall.

Most people who receive specialized treatment for a femur fracture are admitted in a long-term nursing or rehabilitation facility.

Full recovery can take anywhere from 12 weeks to 12 months. Yet, many patients can start walking much earlier with the help of a physical therapist.

In case of surgery, recovery times can vary based on the following considerations:

  • Timing of surgery will depend on if the skin around the fracture is broken or not. Open fractures expose the injury site to the environment and need to be treated immediately.
  • External fixation requires metal screws or pins to be placed into the bone. For patients who need temporary stability before the final surgery, this can add to the recovery times.
  • Intramedullary nailing means inserting a specially designed metal rod to keep the nail and bone in proper position during healing.

How is physical therapy helpful?

Physical therapists design individual treatment plans for every patient. The program is devised to limit broken femur complications and includes exercises that help the patients resume a normal level of activity.

Physical therapy can be helpful by addressing the following issues after injury or surgery:

  • Reduction in pain levels by using heat or ice therapy
  • Resuming motion in the hip, leg and back with exercise and stretching
  • Improving strength with exercise to tone and firm muscles
  • Stabilizing balance using weights, resistance bands or other devices
  • Regaining walking ability
  • Speed up healing
  • Return to daily activities by deciding on recovery goals and the safest methods to achieve them
  • Prevent future re-injury by engineering a home exercise program to strengthen and stretch muscles around the injured area
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Suffering from Rotator Cuff Tear?

By  admin6  published  November 22, 2017

A group of tendons and muscles over the shoulder joint hold the arm in place. They are referred to as the rotator cuff. The rotator cuff is easily one of the most important parts of the shoulder.

The rotator cuff makes it possible to freely move your shoulder and that make sit susceptible to injuries, especially in an accident or due to overuse. Strain or a tear in the rotator cuff can cause severe pain. The best treatment is rotator cuff repair.

Rotator cuff repair is a minimally invasive surgical procedure, performed to fix complete tears. Partial tears have the potential of getting healed on their own with conservative treatments, rest and physical therapy.

The rotator cuff procedure involves insertion of an arthroscope into the affected area through a small incision. The arthroscope allows the surgeon to get a clear view inside the joint and make repairs. Surgical tools are then inserted through other small incisions to repair the tears in the tendons and muscles.

Since the rotator cuff repair surgery is minimally invasive, you may be allowed to go home on the same day as the procedure. After the surgery, you would be advised to not move your shoulder too much. You would need to undergo physical therapy sessions to restore strength and movement in your shoulder. Most patients are able to completely recover from their rotator cuff repair procedure within months.

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Can Knee Cartilage Repair Without Surgery?

By  aenriquez  published  November 16, 2017

Knee cartilage repairCan knee cartilage repair without surgery? Cartilage is essential for the free and painless movement of any joint. A common injury to the knee is to the cartilage in the joint. Cartilage – often referred to as hyaline cartilage – in the knee is soft and spongy and has a number of functions. Firstly, it acts as a shock absorber, absorbing pressure and stopping bone on bone contact during jumping walking and running. Secondly, it maintains the synovial fluid (this is the medical term for the fluid within the joint) within the joint with the right concentrations of salts and other substances. Finally, it provides a smooth surface for joint movement to occur on. By having a smooth surface and stopping bone on bone contact (called eburnation) the joint is able to move freely and without pain. As such, when this cartilage is damaged, pain and an inability to move the joint can occur. This can come on slowly, in the case of osteoarthritis (which is due to long-term wear and tear on the joint) or suddenly, as in the case of a meniscus injury from a twisting motion in sports like Football or Tennis. Either way, the cartilage is often repaired using surgery – but this is associated with a number of risks and is not always ideal for older patients. So can knee cartilage repair without surgery?

One exciting new prospect is regenerative medicine. This stem cell therapy could cause cartilage regeneration. By taking knee cartilage regeneration supplements, patients avoid length and risky surgeries that can actually make the situation worse! There are a number of examples of regenerative medicine for knee cartilage including platelet-rich plasma therapy (whereby somebodies blood without the red blood cells) is given, Bone marrow-derived stem cell injections (as the name suggests, stem cells are taken from bone marrow), Amniotic derived stem cell injections (here stem cells are taken from the amniotic fluid that a baby is surrounded by in the mother’s womb). In platelet-rich plasma therapy, for example, all that is needed is a sample of the patients’ blood. After the platelets are sported out the doctor injects the liquid into the patient painful joint. This is much simpler than a lengthy surgical procedure where patients often have to stay in the hospital to recover. These therapies have been shown to be beneficial in smaller studies for a number of years now. Currently, larger scale studies are underway with promising results. In the future perhaps surgeries to repair cartilage (commonly in the knee but also the elbow, shoulder and other joints) may be a thing of the past!

As we have seen there are options for knee cartilage repair that do NOT involve risky surgery. Regenerative medicine could be the breakthrough many doctors have been waiting for as it is associated with so few risks and has so many benefits.

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Being Managed by One of The Best for a Bicycle Knee Injury

By  aenriquez  published  November 13, 2017

Bicycle Knee InjurykneeOne of the worst orthopedic pathologies one can experience includes a bicycle knee injury. The reason for this is because not only are there three potential bones that can fracture, but numerous another anatomy such as ligaments, tendons, muscles, and soft tissue can be damaged as well. What makes a bicycle knee injury such a potentially problematic trauma is that due to the velocity that an affected individual falls at, this can result in high impact injuries that can involve lots of tissue loss.

Patients who experience severe injuries due to the trauma may end up receiving orthopedic and reconstructive surgeries for the bone and tissue damage sustained. Fractures may include those of the femur (upper leg), patella (knee cap), and/or the tibia and even then fibula (lower leg bones).

Ligament injuries may include those of the collateral ligaments that stabilize the sides of the knee, or the cruciate ligaments which are the support structures inside the knee. If these cruciate ligaments are torn then surgical interventions include either repairing the injured anatomy or replacement of these ligaments with either a donor ligament from the upper leg (graft) or with a synthetic graft if a donor ligament is not appropriate enough.

In order to have the best possible outcomes following such an injury, one will need to be managed by one of the best orthopedic surgeons who specialize in managing such injuries.

One Of The Best  

One of the best orthopedic surgeons specializing in the management of knee injuries is Dr. Sumit Dewanjee, MD, who is based at FXRX in Phoenix, AZ.

Dr. Dewanjee is a Board Certified and Fellowship Trained Orthopedic Surgeon with specialty training in knee surgery to manage injuries, diseases, and disorders affecting this particular joint. The therapies that he is highly competent in performing include the following:

  • Arthroscopy of the knee which entails making small surgical incisions and using small instruments to visualize the inside of the knee and manage any possible problems. Major pathologies such as the mentioned cruciate ligament tears are managed via arthroscopic surgery to improve the recovery time of the patient, as well as to help reduce the risk of any possible complications. Other pathologies such as a tear in the meniscus (cartilage) of the knee are managed this way, too.
  • Partial and total knee replacement surgery which is performed on damaged and severely degenerated knee joints where conservative therapies are no longer helpful or effective.
  • Regeneration of cartilage is performed when there are isolated areas of the knee where the cartilage has worn down, but the patient is not yet a candidate for a total or partial knee replacement. Here, certain procedures, which can only be performed by specialized surgeons such as Dr. Dewanjee, are done which help to stimulate the growth of the missing cartilage in the area where it is needed.
  • Treating arthritis of the knee can be performed by injecting certain medication in the knee joint. The administration of a hyaluronic acid, which is a synthetic type of synovial fluid that is normally found in the knee joints, can only be performed by specialist orthopedic surgeons.
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What is a Shoulder Labral Repair?

By  aenriquez  published  November 8, 2017

Shoulder Labral repairThis injury is common in the news as it keeps professionals athletes out of action for a long time. In 2017 Hyun-jin Ryu of the Dodgers, Andrew Luck of the Indianapolis Colts and Jimmy Nelson of the Milwaukee Brewers all spent extended periods of time watching from the sidelines as a result of a shoulder labral tear. But it’s not just professional athletes that are sidelined by the injury and many people need to undergo what is known as Arthroscopic Labral Repair of the Shoulder or SLAP for short.

Many people suffer from shoulder pain, either brought on suddenly by falling on the shoulder or an outstretched hand or slowly and over time by repetitive strain. Many of these injuries are painful because they cause damage to the labrum of the shoulder joint. The labrum is a portion of soft and fibrous tissue that sits in the glenoid (this is the area of the shoulder joint that joins the bone of the upper arm called the humerus with the shoulder blade and the collarbone). This labrum has a number of functions. Firstly, it allows the joint to move freely and easily without the burns rubbing together (which can be painful). It also acts as a sponge, absorbing shocks taken to the joint. Patients with damage the labrum experience pain when lifting the shoulder and they often have a decrease in the range of movement they are able to achieve. This can be very disabling as the shoulder joint is in constant use in day to day life.

How are should labral tears repaired?

This type of injury often requires surgery to fully recover. The surgery is done arthroscopically to reduce the risk of infection and to provide a faster healing time. Arthroscopic surgery refers to a procedure that is done with a tiny camera instead of opening the entire joint up. This means a much smaller cut is made into the shoulder joint and allows healing to occur a lot faster. The surgeon will then repair the shoulder using small instruments and the small camera inside the shoulder.

After the surgery is complete the shoulder will need to be placed in a sling so it can heal for three-six weeks. During this time the patient is told to perform a number of passive exercises (meaning they get somebody else to move their arm and do not do it under their own power). After the sling is removed the patient will be told to do a number of exercises every day to restore proper muscle power and tone. This is done before the patient returns to strenuous activities like sports.

In some individuals who play sports at a high level the repair is unsuccessful and they may experience some pain or loss of performance for years after. However, on a day to day activities carried out by most patients, an Arthroscopic Labrum repair of the shoulder is a highly successful procedure.

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What are Some Torn Ligament in Knee Symptoms?

By  aenriquez  published  October 27, 2017

There are four ligaments in the knee out of which the lateral collateral ligament is crucial for providing stability. Injury to this ligament is a very common occurrence that can affect optimal knee functioning. As such, it becomes important for athletes and others to be aware of some notable torn ligament in knee symptoms.

What happens in an LCL injury?

The lateral collateral ligament or LCL runs along the outside of the knee joint. Any partial or complete tear of the ligament can seriously impair movement and result in disability in more severe cases.

Depending on the nature of the injury, LCL injuries can be graded into the following categories:

Grade I injuries: Only a minimal amount of fibers get torn resulting in some pain and the individual can still utilize full functioning of the knee.

Grade II injuries: These injuries involve a greater amount of fiber tearing and impair knee function more severely.

Grade III injuries: These serious injuries result in rupturing all the fibers in the knee. The knee becomes severely destabilized and knee mobility/ function is significantly reduced. Grade III injuries may also lead to other complications in the knee area.

torn ligament in knee symptoms to check

Symptoms of an LCL injury

The symptoms of a torn ligament in the knee can range from being very mild to extremely severe. Symptoms are dictated by the severity of the sprain or if the ligament gets torn completely. While mild sprains may not present any noticeable symptoms, partial or complete tears can result in the following:

  • Swelling of the knee
  • Stiffness of knee joint
  • Soreness or pain on the outside of the knee
  • Instability of knee joint
  • Reduced mobility in the area

Swollen knee treatment

Occasionally an LCL injury may happen due to strenuous activity when a lot of pressure is placed on this ligament. Possible scenarios could be a sudden shift in movement putting too much weight on the knee or extending it too far.

In the case of minor injuries, the individual may still be able to pursue regular activity but may experience some stiffness and swelling in the knee. Since both grade I and grade II injuries to the LCL do not involve complete ligament tearing, they may be treated successfully using non-operative techniques.

Typical treatment options will include rest, compression, and cryotherapy with the aim of minimizing the pain and the associated swelling. Injury recovery accessories like a knee brace may be recommended.

Other options include taking pain relievers, keeping the knee elevated and limiting physical activity until the associated discomfort goes away.

Therapy will also involve a range of motion exercises to prevent joint stiffness and to keep the ligaments mobile. For such minor injuries, complete recovery time may take up to six weeks.

Severe LCL injuries, on the other hand, result in a complete tear and require surgical intervention to reconstruct the damaged ligament.

However, surgery is not usually recommended for treating LCL injuries in isolation. The LCL in these cases is often injured along with other ligaments in the knee to necessitate a surgical procedure.

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Effectiveness of Platelet Rich Plasma in treating Knee Injuries

By  admin6  published  October 25, 2017

Platelet rich plasma therapy has been shown to be highly effective in healing painful knee injuries, using a person’s own blood!

What is Platelet Rich Plasma (PRP) Therapy?

Platelet rich plasma is derived from the patient’s own blood and injected into the knee.

Platelets are blood cells that are best known as clotting cells. But they also contain a number of proteins called growth factors. These growth factors can support healing.

In the PRP therapy, the person’s own blood is used to separate the blood cells from plasma. The plasma now contains a high concentration of platelets. This platelet rich plasma is injected into damaged tissues.

Research has shown that PRP or platelet-rich plasma can help with knee injuries and pain, especially those cases that have failed to achieve relief with other treatments.

Platelet-rich plasma has been used to treat the following –

  • Joint instability
  • Joint pain
  • Knee, shoulder, elbow, and other joint injuries
  • Osteoarthritis
  • Carpal tunnel syndrome
  • Sprains and strains

Effectiveness of PRP Therapy

A study in 2009 showed significant improvements in pain, 6 months after the treatment, among 100 people with degenerative cartilage lesions in their knees.

A 2013 study followed 78 patients with osteoarthritis in both knees. Patients who received PRP injections experienced great pain reduction as compared with a group that received placebo injections. Most people obtained relief within a few weeks.

Most studies found few or no side effects. PRP has been shown to be a safe, non-invasive alternative to knee surgery. Since it uses the person’s own blood, no adverse reaction is likely.

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Finding an Orthopedic Doctor for Knee Pain in Tempe Arizona

By  aenriquez  published  September 26, 2017

If you have chronic knee pain, you should see an orthopedic doctor. The decision to undergo knee replacement is a major step toward reclaiming an active lifestyle. However, your knee pain may be treated without surgery. A knee doctor in Tempe Arizona can help you decide which treatment is best for you. Finding the right orthopedic surgeon can mean that you reduce or eliminate knee pain from your life.

Find an Orthopedic SurgeonAsk Your Current Clinicians

When considering an orthopedic doctor for knee pain, you should check with your primary care physician for a list of surgeons who specialize in knee replacement and chronic knee pain. Be sure to ask why the doctor recommends each specialist. You can also check with physical therapists, nurses, and other healthcare workers.

Check with Friends and Acquaintances

Ask friends, family members, and acquaintances who they recommend for the treatment of knee pain. When you make inquiries, ask why these people like the orthopedic knee doctor and find out what treatment options exist.

Insurance Coverage

When choosing a knee doctor in Tempe Arizona, ask your insurance provider who can help you. The insurance company will tell you who is in your plan, who is out of network, and who has a good reputation.

Evaluate the Surgeon’s Credentials

When looking in Tempe Arizona for an orthopedic doctor, spend some time reviewing the doctor’s background, education, training, and degrees. Find out if the doctor is board-certified and by what association.

Check on the Orthopedic Doctor’s Experience Level

If you are considering surgery or interventional procedures, as about the doctor’s experience. What surgeries has he performed? What is his statistics? Has he had good results with non-invasive procedures? Are other patients satisfied? These are things to consider when looking for a knee doctor.

Implant Training/Technology

Orthopedic doctors should have special technical training and education to include implant techniques. The doctor who specializes in knee procedures gains important training through the use of new devices, current surgical approaches, and new technologies. Hospitals sometimes prefer certain manufacturers and devices, so check the facilities in Tempe Arizona when choosing an orthopedic doctor for knee pain.

Experience with High-Risk Cases

Inquire with the orthopedic surgeon regarding experience with high-risk cases of knee pain. Discuss your complete medical history with the surgeon before undergoing any procedures. Be sure he can handle your unique problems and deal with potential complications that can arise.

Meet with the Orthopedic Surgeon

Before choosing a doctor to treat your knee pain, request a consultation with the specialist. Discuss your knee pain, ask questions, solicit an opinion, and review your goals. This gives you a chance to make your decision about treatment. Before your appointment, make sure you understand your pain level and knee history. It is helpful for you to prepare a set of questions to ask the specialist. During your consultation, explain your pain and address your concerns. Ask the knee doctor about his success rate, inquire about his experience in dealing with chronic knee conditions, and bring all your medications.

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